Maternal, newborn, child and adolescent health

Health for the world’s adolescents

World Health Assembly
23 May 2014

At a lunchtime event organized by Norway and the WHO Secretariat, WHO presented “Health for the world’s adolescents,” a dynamic, multimedia, online report. The report describes why adolescents need specific attention, distinct from children and adults, and proposes 10 key actions to strengthen the response of the health sector to improve adolescent health worldwide. The event was co-chaired by Dr Elizabeth Mason, Director of Maternal, Newborn, Child and Adolescent Health, WHO, and Sejal Hathi of the independent Expert Review Group (iERG) for women’s and children’s health, representative of the youth constituency .

A clear theme throughout the event was the importance of meaningfully engaging young people in the design, implementation and monitoring of health programmes that affect them. Panellists – including Ministers of Health from Moldova and Zanzibar, high ranking Ministry of Health officials from India and Norway, and young people from Colombia and Zimbabwe – all stressed the importance and urgency of investing in adolescent health and highlighted both challenges and successes.

Dr Usatii, the Minister of Health from Moldova, illustrated the health sector’s response to adolescents as it is presented in the online report. The systematic approach adopted over the past 10+ years in Moldova is showing effect in expanded health service coverage and small reductions HIV infections among adolescents.

Medicine alone is not enough and that young people need “adolescent services, care and support to help us remain happy, healthy, confident, and to help us survive.”

Ms Maturu, youth voice from Zimbabwe

Dr Ramesh Kumar, Joint Secretary from the Ministry of Health in India, noted that his country is home to the world’s largest youth population, at 253 million. He raised a number of pressing health issues that face India’s youth – like 1.8 million adolescent pregnancies every year, and 47% of India’s maternal deaths occurring among women and girls between the ages of 15 and 24. In 2013, India launched a national strategy on reproductive, maternal, newborn, child and adolescent health (RMNCH + A).

Under the adolescent health strategy launched in 2014, there has been a paradigm shift from a medical approach to one focusing on health promotion, with over 1 million community health workers and peer educators as the backbone of efforts to improve adolescent health. Dr Kumar reminded the audience that we, as a global community, have promised a lot to children born since the Millennium Declaration in 2000, and that we must make good on that promise.

Zanzibar Minister of Health Juma Duni Haji also stressed the importance of engaging young people, their families and their communities to promote the sexual and reproductive health and rights of adolescents. He acknowledged that there are still social and cultural beliefs and practices that can hinder youth’s access to sexual and reproductive health information and services. Despite the challenges of tackling taboo issues, he stressed that we must find ways to do this in order to meet the unmet need for contraception, to delay adolescent marriage and childbearing, and to improve maternal and child health outcomes.

In addition to Ministry of Health participation, the panel also included global youth voices. Dr Daniel Tobon Garcia from Colombia and Loyce Maturu of Zimbabwe moved the audience to their feet with passionate accounts of their work, and strong calls to empower and meaningfully engage adolescents in decisions that impact their health and lives.

Dr Garcia, a recent medical graduate and undertaking a review of the health aspects of youth policy in Colombia, highlighted that more had to be done to address the risk factors for noncommunicable diseases for young people, to improve access to contraceptives for adolescents, and to combat high levels of violence among youth. He stressed that a limitation to current research on youth health – both in Colombia and globally – is a dearth of age-disaggregated data, and urged delegates to insist upon age-disaggregated indicators in the post-2015 framework.

Ms Maturu spoke courageously about her work as a community treatment supporter for HIV positive children and adolescents in Zimbabwe. While more and more children with HIV are getting onto treatment, she explained that adherence to anti-retrovirals (ARV) is not easy for anyone, but is particularly challenging for children and youth. Many of her peers struggle with treatment fatigue, as they have been on ARVs since they were babies.

Ms Maturu also spoke about very practical issues that impede young people’s access to treatment, including clinic hours that mirror school hours. Because of pervasive stigma and discrimination, HIV positive students do not want to go to the clinic during school hours for fear that it will reveal their HIV status. While underscoring the importance of increasing access to ARVs for adolescents, Ms Maturu stressed that medicine alone is not enough and that young people need “adolescent services, care and support to help us remain happy, healthy, confident, and to help us survive.”

In just one week since the launch of “Health for the world’s adolescents,” the report has already been viewed by people in 180 countries. WHO is also spearheading additional consultations on the report, the results of which will guide future action in this area. According to event co-chair Dr Mason, this is not just a report, but the start of something bigger – of ensuring that youth are on the agenda in all areas of WHO’s work, and that they have a seat at the table and a place in the post-2015 development agenda. After all, she concluded, “our future is with our young people”.